Matt Powell, MA, RD, CSSD, CSCS
Tissue injuries (bone, connective, muscle) happen when the load applied to the tissue is greater than the tissues' ability to handle. This could happen from heavy weightlifting where someone attempts a load heavier than the tissue can handle and it strains, rips, tears, breaks etc. It also often happens with no weight when we move at a velocity or in a range of motion the athlete or operator has not prepared for. I’m looking at your former basketball player who tore your Achilles playing pickup for the first time in years. Another common way it happens is when the brain moves rapidly within the skull and the resulting contact leads to bruising, bleeding or other trauma known as a concussion or Traumatic Brain Injury (TBI).
So how do we prevent these from happening?
While the immediate answer, as a strength coach, is to slowly introduce stress to that tissue in specific ranges and progressively increase its tolerance to load, speed, range, etc.
This also got me thinking about what I do with my athletes from a nutritional standpoint to help them PREVENT injuries. We often talk about the importance of nutrition during rehabilitation phases to limit inflammation and promote healthy tissue and growth / recovery. But, what an athlete eats as part of their lifestyle and on a daily basis can also greatly improve their resilience to prevent the injury from ever happening.
With that in mind, I went through and thought about some of the common and important injuries I see daily with both athletes and soldiers in the Special Operations community that I think nutritional support can help. For brevity’s sake, I will break this into two articles, one for the brain and one for all other tissue:
TBI / Brain Injuries -
In the athletic space it is well known for the concussive forces of contact & collision sports like football, soccer and cheerleading (Yes, cheerleading has a ton of concussions in it). What doesn't get talked about as much is all the sub concussive hits and trauma these athletes take. A sub concussive impact is any trauma to the head that causes sudden brain movement without neurological symptoms. This means the athlete is being negatively impacted, but it is not enough to be called a concussion or injury and due to that is rarely ever treated or documented, so the full scope of damage to the brain is unknown to providers, coaches and the athlete themselves.
These sub concussive traumas are also common, likely even more than most athletes, with active-duty soldiers and specifically those in the special operations community. These men and women are constantly at ranges where they get back blasts from larger weapon systems, jumping out of planes and landing from other elevated positions and constant contact and collisions during combat or training leads to a high number of concussive and sub concussive forces and traumas. Due to the increased research to support it, the DOD’s Registered Dietitians (RD’s) are working to add specific supplements to the list of approved supplements they can provide the special operations soldiers to help them combat this and keep them as healthy as possible. Here are the three we recommend and two that we are fighting to make easily accessible and provided to the operator from the units themselves:
Creatine - this is the most researched supplement of all time, with more short- and long-term studies than any other. The research consistently shows the massive benefits of it for strength, power and hypertrophy. What has been shown in more recent studies is the incredible benefit it has for cognitive enhancement and brain health both in the presence and absence of brain trauma, so for preventive care this is a great start for resiliency and overall brain health. The research, mostly done in rodents to start, then proven again in humans, shows that when a brain is injured the creatine in the blood plasma and specifically levels in the brain decrease when trauma, like a concussion, happens. They then showed a larger dose of creatine given to the mice consistently before the brain injury happened was able to help maintain higher levels of creatine in the brain and limit the negative effects afterwards.
Important - it has been proven that you can take creatine consistently for long periods of time with no negative effects. Keeping the plasma creatine levels higher for better recovery from and resiliency towards brain traumas can be a realistic long term solution for operators and athletes alike.
Fish Oil - this supplement has a substantial amount of research and literature behind it. For anyone wanting a good read with actionable protocols, I recommend you go read When Brains Collide. The research on fish oils and their help for healthy people has been well documented and shows the improvements of cognitive function and healthy improvements in cardiovascular capabilities, skin, teeth, bone, hair and vision health. Once the author of that book started using larger doses for brain health and recovery from TBI’s it was shown that the DHA and EPA were able to do amazing things at a cellular level in the brain to promote healing and lead to massive improvements in cognitive function that is often lacking after major brain injuries and concussions.
Once they established baselines dosing and protocols for acute brain injuries they also figured out dosing for preventative measures and noted that a “maintenance dose” of 3g/day is what they recommend.
Important notes - you must choose a high-quality fish oil like Momentous Omega-3 which contains 1.6 grams per serving, so you would just take 4 soft gels per day for a total of 3.2 grams to meet that need. A lot of other companies also source their fish oil from lower quality fish and this can greatly impact the EPA and DHA effective doses, meaning you’d need to take more pills and still may not get the same positive health effects.
Curcumin - this nutraceutical has been shown to work incredibly well as an addition to the creatine and fish oil intake as a way to increase effectiveness of the other supplements, specifically the DHA from the fish oil. One study showed that the increased results from both supplements led to higher levels of brain-derived neurotrophic factor (BDNF) and lower levels of lipid peroxidation, which just means that there was less stress and negative impact from the peroxidation and the levels for BDNF were better and more likely to be in a healthy range.
Important note - you need to make sure your dosing of curcumin from Momentous Turmeric is a bit higher due to low bioavailability.
These three supplements from Momentous are the ones I recommend for my Rangers and other contact or collision athletes I work with. One question I often get asked as an RD by parents is if I would give them to my kids. My answer here is a resounding yes, my 7-year-old daughter who is competitive in soccer and BJJ already takes creatine, and we eat quite a bit of fish and use curcumin and turmeric as spices on her food. These are not just random pieces of advice, but also something I do daily for myself and my family.
To sum it all up, the best way to prevent injuries is to train appropriately for the specific stresses you’ll need to overcome in your sport or job, while also meeting energy and health needs through daily nutrition. To meet these needs, boost recovery and help stave off injury these supplements can be a great way to ensure more resiliency to injury and trauma.
Stay tuned for part two where we look at the rest of the body.
References:
Gilmore N*, Tseng CJ*, Maffei C*, et al. (2024) Impact of repeated blast exposure on active-duty United States Special Operations Forces. Proceedings of the National Academy of Sciences of the U.S.A. DOI: 10.1073/pnas.2313568121
Lewis, M. D. (2016). When brains collide: What every athlete and parent should know about the prevention and treatment of concussions and head injuries. Lioncrest Publishing.
Oliver, J. M., Anzalone, A. J., & Turner, S. M. (2018). Protection before impact: The potential neuroprotective role of nutritional supplementation in sports-related head trauma - sports medicine. SpringerLink. https://link.springer.com/article/10.1007/s40279-017-0847-3
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